Renal-Pulm Final Content

what is the height, width, and depth of a kidney?

12cm, 6cm, 3cm

what is the size of a kidney?

150g / 5-6oz

which kidney is higher?

left

at what vertebral level is the right kidney located?

L3

at what vertebral level is the left kidney located?

T12

what is the hilum?

area of the lung that connects the arterial and venous structures as well as the ureter

what are the three protective tissues of the kidney from innermost to outermost?

fibrous capsule, fat pad, renal fascia

what is the fibrous capsule of the kidney analogous to?

visceral peritoneal

what is the renal fascia made of?

dense fibrous connective tissue

what is the kidney cortex?

outer portion of the kidney

what is the kidney medulla?

2nd layer between the pyramids, lighter in color and contains the tubules of the nephron that form the pyramids of the kidney and the collecting ducts

what are the renal calyces?

chambers of the kidney through which urine passes

how many minor calyces make up a major?

3

what is the function of a major calyx?

drainage associated with each individual pyramid

what is the function of the renal pelvis?

collection of all major calyces, draining into the ureter

how much of our blood is in the kidneys at any given time?

25%

what is the arterial flow of the kidney?

aorta -> renal -> lobar/segmental -> interlobar -> arcuate -> interlobular -> afferent arteriole -> glomerulus -> efferent arteriole -> peritubular capillaries

what is the venous flow of the kidney?

vasa recta -> interlobular v. -> arcuate v. -> interlobar -> segmental -> renal -> inferior vena cava

what is the structure of the renal column?

cortical nephron

what is a cortical nephron?

a nephron with its loop of Henle within the renal cortex

what is the structure of the renal cortex?

juxtamedullary nephron

what is a juxtamedullary nephron?

a nephron with its loop of Henle extending deep into the renal medulla

what is the filtration membrane made up of?

fenestrated endothelium, basement membrane, visceral membrane

what is the function of the fenestrated membrane?

prevents filtration of RBCs

what is the function of the basement membrane?

prevents filtration of large protiens

what is the function of the visceral membrane?

prevents filtration of small protiens

what are peritubular capillaries?

tiny blood vessels that travel alongside nephrons allowing reabsorption and secretion between blood and the inner lumen of the nephron

what are peritubular capillaries associated with?

proximal and distal convoluted tubules

what is the function of the peritubular capillaries?

reabsorption of glucose, amino acids, etc.

what is the vasa recta associated with?

Loop of Henle

what is the function of the vasa recta?

reabsorption of H2O

what are the renal tubules associated with?

proximal convoluted tubules, loop of Henle, distal convoluted tubules

what is the function of the proximal convoluted tubules?

reabsorption of sodium, water, glucose, amino acids, calcium, potassium

what epithelium are the proximal convoluted tubules made of?

cuboidal

what is the only structure in the body supplied and drained by an arteriole?

glomerulus

what is the function of the loop of Henle?

reabsorb water, sodium, chloride

what epithelium is the loop of Henle composed of?

cuboidal and simple squamous

what is the function of the distal convoluted tubules?

regulation of potassium, sodium, calcium, pH

what epithelium are the distal convoluted tubules composed of?

cuboidal

what type of cells are the juxtaglomerular cells?

mechanoreceptors

what is the function of the juxtaglomerular cells?

sense pressure in the proximal convoluted tubule

what type of cells are the macula densa?

chemoreceptors

what is the function of the macula densa?

sense sodium in the distal convoluted tubule, increase of the GFR

how much filtrate do we make daily?

180-200 L

what is filtrate composed of?

blood plasma except for RBCs and proteins

how much urine is produced daily?

1.8-2.0 L

what is urine composed of?

95% water and 5% solutes (waste product)

what affects filtration of the kidneys?

infection, inflammation, diabetes

what is the definition of the glomerular filtration rate (GFR)?

the amount of filtrate the kidneys produce each minute

what is the glomerular filtration rate (GFR) per day?

180-200 L

what is the glomerular filtration rate (GFR) per hour?

7500-8000 mL

what is the glomerular filtration rate (GFR) per minute?

125-138 mL

what increases the GFR?

increased blood pressure, increased fluid intake

what decreases the GFR?

decreased blood pressure, decreased fluid intake, trauma/blood loss

why is the GFR important?

clinical measurement for renal failure

what is net filtrate pressure (NFP)?

Hpg - (Opg + Hpg) = 10 mmHg

what is Hpg?

hydrostatic pressure in the glomerulus (55 mmHg)

what is Hcp?

hydrostatic pressure in the Bowman's capsule (15 mmHg)

what is Opg?

colloid osmotic pressure (30 mmHg)

why is NFP important?

Hpg must be overcome to produce urine - can be a clinical indication of renal failure

where does angiotensinogen come from?

liver

where does renin come from?

kidneys

where does angiotensin I come from?

renin acting upon angiotensinogen

what happens when ACE acts upon angiotensin I?

it becomes angiotensin II

what is the effect of angiotensin II?

stimulation of sympathetic activity

increase Na+, Cl- reabsorption, K+ excretion, H2O retention

stimulation of aldosterone secretion

stimulation of arterial vasoconstriction

stimulation of ADH secretion

stimulation of H2O absorption by collecting duct

what produces atrial naturetic peptide (ANP)?

atria of the heart; cardiac cells

what is the function of ANP?

reduce sodium levels, blood volume, blood pressure

increase urine production

what is the function of the collecting ducts?

final water resorption site

what does ADH have the most effect on?

collecting ducts

what produces antidiuretic hormone (ADH)?

hypothalamus & posterior pituitary gland

what is the function of ADH?

expels water, reduces blood volume, blood pressure

increases urine production

what is the trigone of the bladder?

where two ureters enter and one urethra leaves

what are the three tissue layers of the ureters?

intima, media, adventitia

what is the tunica intima of the ureter composed of?

transitional epithelium

what is the tunica media of the ureter composed of?

smooth muscle (inner longitudinal & outer circular)

what is the tunica adventitia of the ureter composed of?

dense fibrous CT

what are the three layers of the bladder?

intima, media, advenitia

what is different about the composition of the tunica media in the bladder?

3 layers! inner longitudinal, middle circular, outer longitudinal

what is the aka for the tunica media of the bladder?

detrusor (smooth) muscle

what type of muscle is the internal sphincter composed of?

smooth muscle

what type of muscle is the external sphincter composed of?

skeletal muscle

in males, what type of epithelium is the internal sphincter composed of?

transitional stratified columnar

in males, what type of epithelium is the external sphincter composed of?

pseudostratifed columnar

in females, what type of epithelium is the internal sphincter composed of?

transitional stratified squamous

in females, what type of epithelium is the external sphincter composed of?

non-keratinized

what is micuration?

voiding the bladder

what is urination?

passing fluid through a tube to the external enviornment

what is incontinence?

inability to control the external uretheral sphincter

what causes incontinence?

pregnancy, infancy, trauma, old age, stress

what is proanthocyanidin?

found in cranberry juice, helps flush out a UTI

what is mercaptan?

what gives populations who eat a lot of asparagus a unique smelling odor

what is patent urachus?

abnormal connection between umbilicus and bladder in utero

what is the aka for kidney stones?

renal calculi

what are kidney stones composed of?

calcium, magnesium, uric salt

what is a complication of kidney stones?

blockage of a calyx

what is the most common abnormality of the urethra in males?

hypospadis

what is hypospadis?

urethra exits along ventral surface of the penis

when does hypospadis occur?

in utero

what is horseshoe kidney?

inferior poles of both kidneys fuse

how common is horseshoe kidney?

1 in 5-600 births, x2 more common in males